基于多准则决策分析评价骨科大手术后新型口服抗凝药物的综合价值

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中图分类号 R973+.2；R969.3 文献标志码A 文章编号 1001-0408（2025）13-1661-05

DOI 10.6039/j.issn.1001-0408.2025.13.18

Comprehensive value of novel oral anticoagulant drugs after major orthopedic surgery based on multicriteria decision analysis

LIU Xinru12，ZHOU Xindie²，YANG Yang4，GONG Jinhong2，XU Shan²，SU Dan²，SHANG Jingjing²（1.School of Pharmacy，Dalian Medical University，Liaoning Dalian 1160oo，China;2.Dept.of Pharmacy，Changzhou No.2 People’s Hospital Affiliated to Nanjing Medical University，Jiangsu Changzhou 213000，China;3.Dept.of Orthopedics，Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University，Jiangsu Changzhou 213000，China;4.Dept.of Pharmacy，People's Hospital of Hainan Tibetan Autonomous Prefecture of Qinghai Province，Qinghai Hainan 8130o0，China）

ABSTRACTOBJECTIVEToevaluate thecomprehensivevalueof noveloral anticoagulantdrugs（NOACs）after major orthopedicsurgeryMETHODSTheevaluation evidence wascollctedthroughliteratureresearch；evidenceandvalue：impacton decision-making（EVIDEM）frameworkwasintroducedtointegratetheevaluationprocess；themulti-criteriadecisionanalysis （MCDA）methodwasused toconstructamulti-dimensional evaluationsystem；the weightsassignedtoeachevaluationcriterion weredeterminedbythecombinationofDelphi methodandanalytichierarchyprocess，andtherivaroxaban，dabigatranand apixabanwerecomprehensively evaluated.RESULTSTheclinicalcomprehensiveevaluationsystemofNOACsaftermajor orthopedicsurgerywassucessfullyestablished，andthefinalclinicalcomprehensiveevaluationweightsofNOACs（rivaroaban， dabigatran，apixaban）aftermajororthopedicsurgerywerecalculated，withscoresofO.3997forrivaroxaban，0.2444for apixabanandO.3559fordabigatran，indicatingthatrivaroxabandemonstratedthehighestoverallclinicalvalue.Amongthem， rivaroxabanhadtheighestweightscoreintheevaluationofpharmaceuticalcharacteristics，cost-fectivenessandoteraribtes inasingle dimension.In termsof eficacyand safetyevaluation，apixaban hadthehighestweighting score.CONCLUSIONS Among NOACs，rivaroxaban is more suitable for routine anticoagulation management after major orthopedic surgery， especially in terms of pharmacological properties， costeffectivenessandotherattributes.

KEYWORDSmulti-criteria decision analysis；comprehensive clinical evaluation；novel oral anticoagulants；major orthopedic surgery；venous thromboembolism；analytic hierarchy process; DelphiMethod;EVIDEM

静脉血栓栓塞（venousthromboembolism，VTE）是骨科大手术（majororthopedic surgery，MOS）后常见且危害显著的并发症，发病率高达 40%～80% 。（剩余9313字）